NURS 231 PATHOPHYS FINAL EXAM NURS 231 Pathophys Module 5 Exam 2: NUR2755/ NUR 2755 (Lates, Exams of Nursing

Download NURS 231 PATHOPHYS FINAL EXAM NURS 231 Pathophys Module 5 Exam 2: NUR2755/ NUR 2755 (Lates and more Exams Nursing in PDF only on Docsity! NURS 231 PATHOPHYS FINAL EXAM NURS 231 Pathophys Module 5 Exam 2: NUR2755/ NUR 2755 (Latest 2024 / 2025): - Multidimensional Care/ MDC IV Rasmussen- 300 Questions and Verified Answers- Graded A- Rasmussen The respiratory system can be divided into what 2 structures? - Correct Answer Conducting airways and respiratory tissues What are the levels of branching? - Correct AnswerTrachea, bronchi, bronchioles, alveoli Where is the site of gas exchange? - Correct AnswerAlveoli What cells are in the alveolar epithelium? - Correct AnswerType 1 and II alveolar cells, macrophages Describe what happens during inspiration and expiration: - Correct AnswerDuring inspiration, air is drawn into the lungs as the respiratory muscles expand the chest cavity. During expiration, air moves out of the lungs as the chest muscles relax and the chest cavity becomes smaller. What occurs with the diaphragm during inspiration and expiration? - Correct AnswerThe diaphragm is the main muscle of inspiration. When the diaphragm contracts (inspiration), the chest expands. Upon expiration, the chest cavity decreases and pressure inside increases. What is lung compliance? What factors affect it? - Correct AnswerLung compliance is the ease with which lungs can be inflated. Elastin, collagen, elastic recoil, and surface tension can affect lung compliance. Lung Volumes - Correct AnswerThe amount of air exchanged from a single event during ventilation (measure by a spirometer) Tidal Volume (Vt) - Correct Answernormal volume of air inhaled or exhaled with each breath Inspiratory Reserve Volume (IRV) - Correct Answeramount of air that can be forcefully inhaled after taking a normal breath Expiratory Reserve Volume (ERV) - Correct AnswerAmount of air that can be forcefully exhaled after taking a normal breath Residual Volume (RV) - Correct AnswerAir remaining in the lungs after forced expiration (cant be measured with spirometer) Vital Capacity (VC) - Correct Answeramount of air that can be exhaled after maximal inhalation. (VC=Vt + IRV + ERV) Inspiratory Capacity (IC) - Correct AnswerMax amount of air that can be inhaled following a normal expiration (IC= Vt + IRV) Functional Residual Capacity (FRC) - Correct Answerthe amount of air that remains in the lungs after a normal expiration (FRC= RV + ERV) Total Lung Capacity (TLC) - Correct Answersum of all lung volumes (TLC= IRV + Vt + ERV + RV) pulmonary function tests - Correct AnswerObserve pulmonary flow in relation to time. Used to diagnose respiratory disease or to examine respiratory complaints. Or can be used as a pre op anesthesia or surgical risk evaluation - stop smoking to slow disease progression - pneumonia and flu vax - inhaled short and long acting bronchodilators, to relax airway smooth muscle - oxygen therapy when PCO2 levels drop below 55 mmHg What are the characteristics of asthma? - Correct AnswerAsthma is a chronic respiratory disease characterized by airway obstruction, bronchial hyperresponsiveness, airway inflammation, and in some cases, airway remodeling. chronic bronchitis and emphysema - Correct Answer-Chronic bronchitis is a clinical diagnosis: chronic cough productive of sputum for at least 3 months per year for at least 2 consecutive years. -Emphysema is a pathologic diagnosis: permanent enlargement of air spaces distal to terminal bronchioles due to destruction of alveolar walls What is atopy? - Correct AnswerAtopy is the genetic tendency for developing IgE- mediated hypersensitivity reactions in response to environmental allergens. It is one of the strongest predisposing factors for developing asthma. Be familiar with the risk factors, disease pathology, clinical presentation, diagnosis, and treatment of asthma. - Correct Answer1. risk factors 1. atopy, family history of asthma, allergies, prenatal exposure to tobacco smoke and pollution, gastro-esophageal reflux disease, exercise, cold air, being African American or Puerto Rican decent. 2. pathology swelling of bronchial wall, mucus secretion, airway constriction, airway inflammation, bronchial hyper-responsiveness, and airflow obstruction 3. clinical presentation - asthma attacks- wheezing, breathlessness, chest tightness, cough that is typically worse at night and early morning. - Lung sounds wheeze during expiration. 4. diagnosis: - Pulmonary function tests, patient history and physical exam - airway obstruction will show a reduced FEV1 and FEV1/FVC ratio of <70% - Hallmark asthma: increase of FEV1 of > 11% after bronchodilator is a diagnostic hallmark of asthma. What is pneumothorax? - Correct AnswerPneumothorax is the presence of air in the pleural space that causes partial or complete collapse of the affected lung. Be familiar with the risk factors, disease pathology, clinical presentation, diagnosis, and treatment of pneumothorax. - Correct Answer1. Risk factors: - spontaneous: tall boys between 10 and 30 due to difference in pleural pressure from top to bottom of lung. Lung disease, especially emphysema. 2. Disease pathology: Tension occurs when air enters pleural space but cant exit, such as penetrating chest wound. It can collapse the lung on affected side and compress mediastinal structures. 4. clinical presentation: -chest pain on affected side, increased rest rate and difficulty breathing. 5. diagnosis: chest x ray or CT scan 6. treatment: air removed by needle or closed drainage system w or wo suction. What is atelectasis? - Correct AnswerAtelectasis is an incomplete expansion of a lung, or portion of lung, caused by airway obstruction or lung compression. Be familiar with the risk factors, disease pathology, clinical presentation, diagnosis, and treatment of atelectasis. - Correct Answer1. Risk factor and pathology - newborns w respiratory distress syndrome (results form lung never been inflated or impaired lung expansion). -Adults: mucus plug in airway or compression by fluid, tumor mass, exudate, anything else. - risk increased following surgery. Anesthesia, pain and pain meds, immobility 2. Clinical presentation - rapid breathing (tachypnea), tachycardia, dyspnea, cyanosis, signs of hypoxemia, diminished chest expansion, decreased breath sounds. 3. Diagnosis: - signs and symptoms and chest x ray or CT scan 4. treatment - oxygen administration, ambulation (walking around), deep breathing What type of substance causes a pulmonary embolism? - Correct AnswerThe embolism may be a thrombus, air accidentally injected into an intravenous infusion, fat from the bone marrow after a fracture or trauma, or amniotic fluid that enters the maternal circulation after rupture of membranes. Be familiar with the disease pathology, clinical presentation, diagnosis, and treatment of pulmonary embolism. - Correct Answer1. Path: - substance lodges in branch of pulmonary artery and obstructs blood flow. It causes obstruction of blood flow which leads Treatment: Aimed at improving ventilation A bodybuilder's muscles will display hyperplasia. - Correct AnswerFalse Barrett esophagus is an example of dysplasia - Correct Answerfalse hypertrophy is an increase in the size of an organ or tissue caused by an increase in the number of cells - Correct AnswerTrue Lack of nerve stimulation can cause cells to atrophy - Correct AnswerTrue proportion of people with a disease who are positive for the disease - Correct Answersensitivity how likely the same result will occur if repeated - Correct Answerreliability how a tool measures what it is intended to measure - Correct Answervalidity people without the disease who are negative on a given test - Correct Answerspecificity Which is NOT true of the cytoskeleton? - Correct Answerit includes peroxisomes and proteasomes Which of the following are true of the cell? Select all that apply. - Correct Answer1: Proteins carry out the functions of the cell membrane 2:Lysosomes are the digestive system of the cell 3:Microfilaments are thin, threadlike cytoplasmic structures Which are true of the cell membrane? Select all that apply. - Correct Answer1: Controls the transport of materials from the outside fluids to within 2:Helps with the conduction of electrical currents in nerve and muscle cells 3: Aids in the regulation of cell growth and proliferation Which are false of the mitochondria? Select all that apply. - Correct Answer1: They are found far from the site of energy consumption. 2:They control free radicals. High blood pressure is an example of which of the following? - Correct Answerpathophysiology A patient complains of chest pain and an elevated blood pressure. What are these examples of? - Correct Answersigns and symptoms Which of the following is true of a test's sensitivity? - Correct AnswerIf negative, it can safely be assumed that the person does not have a disease Chemical agents (poison, alcohol) are examples of which of the following? - Correct AnswerEtiologic factors Define tertiary prevention and give an example: - Correct AnswerTertiary prevention occurs after a disease has been diagnosed and clinical intervention is needed to reduce complications or deterioration. One example is the use of certain medications one must take after a heart attack to help reduce the risk of a future event or death. Compare and contrast the two types of gangrenous necrosis. - Correct AnswerIn dry gangrene the affected tissue becomes dry and shrinks, the skin wrinkles, and its color changes to dark brown or black. The spread of dry gangrene is slow. It results from a cut off in arterial blood supply and is a form of coagulation necrosis. In wet gangrene, the affected area is cold, swollen, and pulseless. The skin is moist, black, and under tension. Blebs form on the surface, liquefaction occurs, and a foul odor is caused by bacterial action. The spread of tissue damage is rapid. Explain what necrosis is and give an example and description of one type of necrosis. - Correct Answernecrosis is cell death to an organ or tissue with still being apart of a living person. An example of this would be luiquefactive necrosis. this is when the cells die and the catalytic enzymes do not get destroyed after the cells death. This could cause necrosis sunburn - Correct Answerradiation injury obesity - Correct Answernutritional imbalances reactive oxygen species - Correct Answerfree radical injury low oxygen to tissues - Correct Answerhypoxic cell injury fractures - Correct Answerphysical agents OTC drugs - Correct AnswerChemical injury hypothermia - Correct Answerphysical agents radiation treatment - Correct Answerradiation injury lead toxicity - Correct Answerchemical injury bacteria - Correct Answerbiologic agents List the 4 types of tissue found in the body. Pick 2 and give a description and example of each. - Correct AnswerEpithelial tissue- covers the body's outer surface, it is avascular and gets its o2 from the capillaries found in the neighboring connective tissues, and example of this is simple squamous tissue which means one layer of thin cells. Muscular tissue Nervous tissue- is found all throughout the body, helps with communication between tissues and the central nervous system. it aids in the functions of the body due to internal and external stimuli, helps with movement, and electrical signaling. neurons are an example of this, they aid in communicating to other cells in the body, they are held and supported by glial cells. Connective tissue What term means "cell eating" and engulfs and then kills microorganisms or other particulate matter? - Correct AnswerPhagocytosis What is the term to describe when cells use energy to move ions against an electrical or chemical gradient? - Correct AnswerActive transport Give one function of a membrane potential: - Correct AnswerGenerate nerve impulse, muscle contractions, or cause hormone secretion What is the term that best describes the following process? A transport protein aiding a lipid insoluble or large molecule across the cell membrane that would otherwise not be able to pass through on its own. - Correct Answerfacilitated diffusion Blood tests for tumor markers can make a diagnosis of cancer. Why or why not? - Correct AnswerFalse, only tissue can diagnose. Tumor markers are helpful to assess response to therapy or reoccurrence. Tissue biopsy is of critical importance in what role? - Correct AnswerDiagnosing the correct cancer and histology. Explain the TNM system: - Correct AnswerT is the size and local spread of the primary tumor. Lab: pap smear swabbing for cervical cancer Explain the challenges of diagnosing autoimmune disorders. - Correct AnswerThere are over 80 identified, many with overlapping presentations. Many manifestations are nonspecific and are seen in other non-autoimmune diseases. Blood testing isn't perfect either, as some tests are more generic and can be elevated in the presence of other diseases. Which cell is the first responder to phagocytose a foreign invader? - Correct Answermonocyte What allows the lymphocyte to differentiate between self and foreign molecules? - Correct AnswerMajor histocompatibility complex (MHC) molecule T lymphocytes produce what type of immunity? - Correct AnswerCell-mediated Which immunoglobulin passes immune factors from the mother to the fetus? - Correct AnswerIgG Which cell type is an early responder and the most abundant in the body? - Correct AnswerNeutrophils Which feature is NOT of adaptive immunity? - Correct AnswerEpithelium is a defense mechanism A 12-year-old female presents with itchy eyes, nasal congestion and drainage, and sneezing every spring when the pollen count is high. (1) Explain the immunologic mechanisms that are responsible for her symptoms. (2) What type(s) of treatment might be used to relieve her symptoms? - Correct Answer1) Mast cells, basophils, and eosinophils play an important role in the development of type I reactions because they contain the chemical mediator histamine. A primary or initial-phase response is vasodilation, vascular leakage, and smooth muscle contraction. A secondary or late- phase response is characterized by more intense infiltration of tissues with eosinophils and other acute and chronic inflammatory cells, as well as tissue damage. (2) Antihistamines and intranasal corticosteroids are the mainstay of treatment. A narrow, surgical-type wound is likely to heal by secondary intention. - Correct Answerfalse Which of the following is an incorrect pairing of a classic manifestation of acute inflammation with its corresponding cause? - Correct AnswerDolor - inflammatory cells infiltrating sensory nerves B cells are primarily associated with humoral immunity. - Correct Answertrue T cells mature in the thymus and are active in cellular immunity. - Correct Answertrue B lymphocytes normally produce antibodies against host tissues. - Correct Answerfalse Antibodies are also known as ______? - Correct Answerimmunoglobulin Which of the following hypersensitivity reactions can be treated with the administration of epinephrine - Correct Answertype 1 Which cell is NOT part of the adaptive immune response? - Correct Answermonocytes Features of systemic lupus erythematosus include all of the following except - Correct AnswerExophthalmos What are the 2 factors that play a role in the development of autoimmune diseases? - Correct Answergenetics and environmental factors A 40-year-old man presents with cough and shortness of breath. After an H&P and chest films, it is determined he has pneumocystis carinii pneumonia (PCP). The provider does an HIV test, which is positive. Upon further testing, the man's CD4+ cell count is 100 cells/µL and his viral load is 250,000 copies/mL. (1) Why did the provider do an HIV test after the man was diagnosed with PCP? (2) What classification does this man fall into based on his CD4+ count and symptomatology, and why - Correct Answer(1) Opportunistic infections are those common organisms that do not produce infection without impaired immune function. (2) The last phase, or AIDS illness, occurs when the CD4+ cell count falls to less than 200 cells/µL or exhibits an AIDS- defining illness. The risk of opportunistic infections and death increases significantly when the CD4+ cell count falls below 200 cells/µL. Which process is NOT included in wound healing? - Correct AnswerAcute-phase response While labile and stable cells can regenerate themselves, _______ cells are unable to undergo mitotic division. - Correct AnswerPermanent cells ____ disorders occur when the immune system fails to differentiate self from non-self. - Correct Answerautoimmune The time between HIV infection and seroconversion is called what? - Correct Answerthe window period A person with HIV is not infectious when they are asymptomatic. - Correct AnswerFalse The T cells that display the host's MHC antigens and T-cell receptors for a nonself- antigen are allowed to mature, a process termed negative selection. - Correct AnswerFalse What cell mediator is the primary cause of vasodilation seen in acute inflammation? - Correct AnswerHistamine The three stages of hemostasis include each of the following except: - Correct AnswerVascular dilation Which cell in the blood provides primary hemostasis - Correct AnswerPlatelets Which of the following medications would decrease a person's risk for clotting? Select all that apply. - Correct Answer1: Heparin 2: warfarin 3: lovenox Which of the following is a hypercoagulable state? Select all that apply. - Correct Answercongestive heart failure, smoking, and post-surgical state Which of the following are TRUE of hemophilia A? Select all that apply. - Correct AnswerSpontaneous joint bleeding can occur, The PTT is increased Which is NOT included in the three principles of blood flow? - Correct AnswerCompliance Which of the following does NOT affect the heart's ability to increase its output? - Correct AnswerCardiac reserve Which of the following is true of the renin-angiotensin-aldosterone system? - Correct AnswerAngiotensin II increases sodium reabsorption in the kidney by stimulating the secretion of aldosterone Which of the following does NOT lead to an increased risk for DVT? Select all that apply. - Correct AnswerNon-smoker What lifestyle modifications would you suggest for them? Name one medication therapy for hypertension and its mechanism of action. - Correct AnswerHypertension stage 2 Atherosclerosis, CAD (MI), heart failure, stroke, peripheral artery disease Lose weight, exercise, decrease salt intake, decrease alcohol intake Diuretics, like thiazides, lower blood pressure by decreasing vascular volume; Even after forced expiration, a significant amount of air remains in the lungs. - Correct AnswerTRUE Nearly all pulmonary emboli are thrombi arising from deep vein thrombosis in the upper and lower extremities. - Correct Answertrue ______ measures expiratory volume in a given time. - Correct AnswerForced expiratory volume (FEV) The _____ are the actual sites of gas exchange between the air and blood. - Correct Answeralveoli Intrapleural pressure is always negative in relation to alveolar pressure in a normal inflated lung. - Correct Answertrue During inspiration, air is drawn into the lungs and the chest cavity is decreased. - Correct Answerfalse The diaphragm is the primary muscle of inspiration - Correct Answertrue Excess surface tension makes lung inflation harder. - Correct AnswerTrue Lung volumes can be measured using a ______. - Correct Answerspirometer _____ is the flow of gases into and out of the alveoli of the lungs. - Correct AnswerVentilation Which of the following cells contribute to airway inflammation in asthma? Select all that apply. - Correct AnswerEosinophils, mast cells, neutrophils, Leukotrienes, and lymphocytes Alpha-1 antitrypsin deficiency is most likely seen in which disease process? - Correct AnswerEmphysema Histologically, chronic bronchitis would exhibit each of the following except: - Correct AnswerEnlargement of the airspaces Each of the following are TRUE of ARDS except: - Correct AnswerPresents with decreased respiratory rate A 30-year-old man is brought to the ER with a knife wound to the chest. On visual inspection, asymmetry of chest movement during inspiration, displacement of the trachea, and absence of breath sounds on the side of the wound are noted. His neck veins are distended, and his pulse is rapid and thready. What is your initial diagnosis? What type of emergent treatment is necessary? - Correct Answer1) tension pneumothorax 2) chest tube When is the risk for obstructive atelectasis the greatest? What are strategies to decrease the chance for developing atelectasis? - Correct AnswerThe risk of obstructive atelectasis is increased following surgery. Anesthesia, pain and pain medications, and immobility promote retention of bronchial secretions. Patients are encouraged to frequently cough, deep breath, change positions, hydrate adequately, and ambulate early to prevent atelectasis. Explain why the oxygen flow rate for people with COPD is normally titrated to maintain the arterial PO2 between 60 and 65 mm Hg. - Correct AnswerTheir medullary respiratory center has adapted to the elevated CO2 levels and no longer responds to increases in PCO2. Therefore, a decrease in PO2 becomes the stimulus for respiration. If oxygen is given at too high of a rate, it suppresses the stimulus and the respiratory drive. Each of the following can lead to atelectasis except: - Correct AnswerThrombus Someone with COPD would exhibit each of the following characteristics except: - Correct AnswerIncreased D-dimer levels Ventilation - Correct AnswerThe flow of gases into and out of the alveoli of the lungs Perfusion - Correct AnswerThe flow of blood in the adjacent pulmonary capillaries Diffusion - Correct AnswerThe transfer of gases between the alveoli and the pulmonary capillaries Each of the following disorders are correctly paired with related characteristics except: - Correct AnswerAtelectasis - decreased respiratory rate A patient has experienced a seizure affecting the left temporal lobe. The family reports that the patient exhibited repetitive lip smacking and hand rubbing followed by a period of great fear and insecurity. They have experienced which type of seizure? - Correct AnswerFocal seizure with impairment of consciousness or awareness Voluntary tongue movements are controlled by which cranial nerve? - Correct AnswerCN XII. You are seeing a patient with Parkinson's disease in your office. You feel a catch as you passively take their arm through flexion and extension. This is an example of what physical manifestation of the disease? - Correct AnswerCogwheeling Sleep spindles are characteristic of which stage of sleep? - Correct AnswerStage 2 A person reports a generalized depressed mood, changes in appetite, and irritability that gets worse as the day goes on. They also report that they sleep more than 8 hours which is affecting their productivity. What type of depression are they experiencing? - Correct AnswerAtypical depression Each of the following statements is true regarding the organization of the nervous system except: - Correct AnswerThe CNS has an afferent and efferent division Each of the following statements is true regarding Alzheimer's disease except: - Correct AnswerNeurofibrillary tangles are composed of deteriorating nerve pieces that arrange themselves around a sticky protein core called amyloid beta (Aβ) Each of the following are modifiable behaviors related to stroke except: - Correct AnswerHypercholesteremia Primary insomnia is characterized by each of the following except: - Correct AnswerCan also be called comorbid insomnia What type of seizure occurs in 2 phases, involves a loss of consciousness, and lasts approximately 60-90 seconds? - Correct AnswerTonic-clonic seizure Sleep disturbances associated with narcolepsy include each of the following except: - Correct Answersleep apnea Each of the following statements is true of Parkinson's disease except: - Correct AnswerIt is characterized by an increase of dopaminergic neurons Complications of gallstones include each of the following EXCEPT: - Correct AnswerCirrhosis Treatments for gastroesophageal reflux include each of the following EXCEPT: - Correct AnswerCaffeinated beverages Treatment of irritable bowel syndrome includes each of the following EXCEPT: - Correct AnswerAnti-diarrheal medication Each of the following factors are associated with increased incidence of peptic ulcer EXCEPT: - Correct AnswerDietary history The most common complication of peptic ulcers is _____. - Correct AnswerGastrointestinal bleeding Each of the following are characteristics of ulcerative colitis EXCEPT: - Correct AnswerGranulomatous lesions Each of the following are characteristics of Crohn disease EXCEPT: - Correct AnswerBloody diarrhea The process of digestion begins in the stomach and finishes in the large intestine. - Correct AnswerFalse is the process of moving nutrients and other materials from the external environment of the GI tract into the internal environment. - Correct Answerabsorption The double layer of peritoneum that holds the organs in place and stores fat is called what? - Correct Answermesentery What type of cell secretes gastrin? - Correct AnswerG cells The amplitude and frequency of the slow waves is regulated by ______? - Correct AnswerEnteric nervous system Activation of the parasympathetic nervous system increases the amplitude of the slow waves. - Correct AnswerTrue is a linear chain of interconnecting neurons located between the circular and longitudinal muscle layers, involved with GI motility? - Correct AnswerMyenteric (Auerbach) plexus Food is converted in the stomach into a creamy mixture called? - Correct Answerchyme Which GI hormone has strong growth hormone-releasing activity and stimulates food intake and digestive function? - Correct AnswerGhrelin Which GI hormone inhibits gastric acid secretion? - Correct AnswerSecretin Anti-diarrheal medication can be used with all types of diarrhea. - Correct AnswerFalse Constipation and a low fiber diet are a major risk factor for developing what disease? - Correct Answerdiverticulosis Clinical manifestations of cirrhosis include each of the following EXCEPT: - Correct AnswerPancreatitis What is now the most common cause of chronic liver disease in the Western world? - Correct AnswerNonalcoholic fatty liver disease (NAFLD) A patient presents with right upper quadrant pain, that worsens after eating a fatty meal. What would be the best imaging modality to evaluate their complaint? - Correct AnswerAbdominal ultrasound Excessive red blood cell destruction would cause what type of jaundice? - Correct AnswerPrehepatic jaundice Each of the following statements are true regarding control over the GFR except: - Correct AnswerThe RAA responds when blood pressure rises above normal limits. Which of the following statements is false regarding ADH? - Correct AnswerElevated levels of ADH will lead to dilute urine. Cortical nephrons are characterized by the following except: - Correct AnswerThey originate deep in the cortex Excess accumulation of fluid within the interstitial compartment is characteristic of which of the following fluid imbalances? - Correct AnswerEdema Reabsorption in the loop of Henle is characterized by the following except: - Correct AnswerNa+ and water are reabsorbed in equal proportions Which of the following is/are true regarding acid-base balance? (mark all that apply) - Correct AnswerAcid-base balance refers to the balance of the concentration of hydrogen ions (H+) in the blood, Venous blood is characterized by a more acidic pH, A higher concentration of OH- ions will increase the pH of the blood Acute postinfectious glomerulonephritis is characterized by the following except: - Correct AnswerAssociated with a poor prognosis as it often leads to CKD Which of the following is characteristic of chronic transplant rejection? - Correct AnswerInvolves humoral immunity Which of the following is true of 1,25-dihydroxycholecalciferol? - Correct AnswerIt is the active form of vitamin D, converted in the kidney A patient is said to be in stage 4 kidney disease. What would you expect their GFR to be? - Correct AnswerA. 25 mL/min/1.73m2 The following are true regarding tubular secretion except: - Correct AnswerK+ is secreted in the intercalated cells A decrease in Na+ reabsorption is achieved through the action of which of the following? - Correct AnswerDiuretics In the nephron, the mass of capillaries surrounded by an epithelial capsule that opens into a tubule is collectively referred to as the _______. - Correct Answerrenal corpuscle The hormone that is synthesized in the kidneys and regulates the differentiation of red blood cells is _______. - Correct Answererythropoietin The enzyme ___________ causes CO2 to react reversibly with water to form carbonic acid (H2CO3) to regulate blood pH. - Correct Answercarbonic anhydrase A person who has a blood Mg2+ concentration of 1.2 mg/dL. Is considered to have _______. - Correct Answerhypomagnesemia _______ failure is caused by conditions that damage the structures within the kidney. - Correct AnswerIntrarenal Angiotensin I is converted to angiotensin II in the kidneys. - Correct AnswerFalse, angiotensin I is converted to angiotensin II in the lungs. The posterior pituitary releases which of the following hormones? Select all that apply. - Correct AnswerOxytocin, ADH Type 2 diabetes mellitus is associated with each of the following characteristics EXCEPT: - Correct AnswerBeta cell mass markedly reduced Each of the following are characteristics of diabetes mellitus EXCEPT: - Correct AnswerMyxedema Of all the people with diabetes, approximately 70% have type 2 diabetes. - Correct AnswerFalse Gluconeogenesis, or glucose formation, is promoted by the alpha cells. - Correct AnswerTrue Most hormones are controlled through positive feedback. - Correct AnswerFalse Those with prediabetes have an increased risk of atherosclerotic heart disease. - Correct AnswerTrue Testing for diabetes should be done on everyone initially at age 60. - Correct AnswerFalse A 45-year-old obese, sedentary male has recently been diagnosed with type 2 diabetes. What are 2 strategies to help him normalize his blood sugars? List 2 other macrovascular complications he is at risk for and how you would screen for them? - Correct Answer(1) Diet, exercise, and weight loss may be all that they need to control blood glucose levels. Even moderate weight loss of 5-10% of total body weight has been shown to improve glucose control. (2) Hypertension and hyperlipidemia - checking blood pressure and screening with a serum lipid panel. A diabetic's risk of macrovascular diseases is 2-4 times higher and the leading cause of death among diabetics (50-75%) is from a macrovascular disease. Name 3 of the 4 complications listed: - Correct AnswerPeripheral vascular disease, coronary artery disease, heart attack, and stroke Hypothyroidism is caused by each of the following EXCEPT: - Correct AnswerThyroid adenoma A 40-year-old woman presents with amenorrhea and weight loss despite increased appetite. The history and physical exam show exophthalmos, tachycardia, and warm, moist skin. Each of the following lab abnormalities are expected EXCEPT: - Correct AnswerIncreased TSH Your diabetic patient with neuropathy is at risk for developing a foot ulcer. How would you instruct him to care for his feet? List at least 3. - Correct AnswerWear proper fitting shoes, daily feet inspection to look for blisters, sores, or signs of infection. Avoid smoking, cold temperature, bare feet. ______ is defined as a blood glucose of <60 mg/dL, with associated cognitive impairment. - Correct AnswerHypoglycemia The risk factors for _____ _____ include hyperglycemia, hypertension, hyperlipidemia, obesity, altered platelet function, endothelial dysfunction, elevated fibrinogen levels, and systemic inflammation. - Correct AnswerMacrovascular complications / disease ___ ____ is diagnosed by hyperglycemia, low serum bicarbonate, and low pH, with ketonemia and moderate ketonuria. - Correct AnswerDiabetic ketoacidosis (DKA) Which oral antidiabetic drugs increase GLP-1 and GIP, which increase insulin release and decrease glucagon levels. - Correct AnswerDPP-4 inhibitors Each of the following are true of gout except: - Correct AnswerA serum uric acid level greater than 6.8 mg/dL without symptoms leads to a diagnosis of gout Which of the following would a patient likely report if you suspect they have OA? - Correct AnswerStiffness in the morning that resolves in less than 30 minutes Which of the following are true regarding syndesmoses? (mark all that apply) - Correct AnswerThey allow a small degree of movement between them, They are separated by a fibrous disc Cortical bone receives its blood supply through the following means except? - Correct AnswerDiffusion through the endosteal surface of the bone and the canaliculi What is the recommended calcium intake for premenopausal women? - Correct Answer1000 mg. daily Which of the following cells regulate bone growth through the secretion of growth factors and tumor necrosis factor? - Correct AnswerOsteoblasts Which of the following contribute to joint destruction associated with OA? (mark all that apply) - Correct AnswerDamaged chondrocytes, Interleukin -1beta, Tumor Necrosis Factor-Alpha, An imbalance of protease and protease inhibitors A patient has low serum calcium levels. Which of the following is true given this scenario? - Correct AnswerPTH will increase renal reabsorption of calcium while simultaneously increasing renal excretion of phosphate A diagnosis of gout is made through which of the following tests? (mark all that apply) - Correct AnswerBlood work to determine uric acid levels, Analysis of synovial fluid, 24-hour urine specimen In the early stages of OA, structural changes would include which of the following? (mark all that apply) - Correct AnswerEdema in the cartilaginous matrix Which of the following is false regarding the synovium? - Correct AnswerThe synovium surrounds the margins of articulation and lines the articulating surfaces of the joint Senile Osteoporosis is characterized by which of the following? (mark all that apply) - Correct AnswerFractures of the hip joint, A direct relationship between aging and rate of bone loss A T-score compares the bone of the patient to that of a healthy 20-year-old adult. - Correct Answerfalse; healthy 30 yr old Haversian canals contain the nerve and blood supply for the osteon. - Correct Answertrue Hyperuricemia may be a result of an underproduction of purines. - Correct Answerfalse; it is an overproduction of purines Prolonged immobilization can lead to structural joint changes associated with OA. - Correct Answertrue If someone loses their balance when walking on uneven terrain, explain how tendons and ligaments work to protect the joint and structures within it. - Correct AnswerThe tendons and ligaments of joints serve in proprioception (the awareness of ones' position in space or movement of the body). When these structures undergo stretch or torsional strain, these proprioceptive nerve fibers will cause a reflexive response to adjust the tension on the muscles (to maintain balance and not fall over) that support the joint protecting the capsule and other joint structures. A patient presents to the ER with severe pain in their right ankle. Blood tests reveal serum uric acid levels of 7.8 mg/dL. They are kept for observation and their 24-hr urine